Yes No If required for a minor, was informed consent for psychotherapeutic medication completed and given to the parent or guardian? Post-traumatic stress disorder, impulse control disorder, not otherwise specified. Discharge Summary Sample Mental Health. VA Palo Alto Medical Center Palo Alto, CA Hospice and Palliative Care Nurse 03/2000 to 10/2006. Once you have found another physician and we receive DISCHARGE DIAGNOSES: AXIS I: 1. AXIS II: Mild mental retardation. Discharge Date: 08/05/14 . Para. Page 1A of 7 PSYCHIATRIC CLINIC, LLC 123 Main Street Anywhere, US 12345-6789 555-678-9100 (O) 555-678-9111 (F) DATE ADMITTED : 4/24/2017 DATE DISCHARGED : 7/20/2017 This discharge summary consists of 1.Initial Assessment 2. letter) while you have an opportunity to arrange for another. Behavioral Health Discharge Summary For BCN HMOSM (commercial), BCN AdvantageSM and Blue Cross Medicare Plus BlueSM PPO members Revised effective Oct. 2, 2017 Complete this form and attach it to the case in the e-referral system, in the Case Communication field. Date of Admission/Transfer: Date of Discharge/Transfer: Admitting Diagnosis: This should be your working diagnosis at the time of admission (not the chief complaint/presenting symptoms). There is ample evidence that mental health, substance abuse and co-occurring (i.e. discharge summary template sample templates. Discharge Summary Template Mental Health. Important information to include regarding the patient includes: 1. Health Details: Discharge Summary medicaid ID:M6 Room No. Date of Birth 3. substance abuse and mental health) providers are doing a poor job of planning for the discharge of clients from their system of care into that of others. In general, discharge planners will begin to provide a more firm and concrete discharge day when there are fewer uncertainties and unknowns to be addressed in your projected prognosis. Discharge Summary for Mental Health Treatment Programs VAC Area Counsellor (Case Manager): VAC File No. 6.b states that discharge processing is appropriate when a mental health practitioner makes the … This problem is not unique to the mental health and substance abuse treatment fields as discharge planning At the moment I am working on a project revolving around mental health, and I have been looking and looking for a mental health discharge plan that I can use as an example so as I may be able to create my own for a presentation. The discharge summary informs outpatient medical or mental health workers about services provided by … mental health discharge summary billing form. Presenting problem (include diagnostic information, if available): NO REFERENCE NEEDED A Discharge Summary is created when a patients case is closed and referred to another provider either by discharge from an inpatient or outpatient program. Discharge or transfer of care should be considered for Adult Mental Health Service consumers in the following instances: Persons approaching 65 years of age. Referral Source: Psychiatrist Family Physician Psychologist Social Worker Other:_____ 2. Patient Name: Russell Johnson . Course in Treatment 3. The discharge summary provides a synopsis of the patient’s history and their examination, care, and treatment at the Montana State Hospital (MSH) Forensic Mental Health Facility (FMHF). The following Discharge Summary sample was created in … Primary Care Physician: Dr Dianna Miller . could jeopardize your health, so please act promptly. Yes No Was a discharge plan discussed with the member? Home » Templates » Discharge Summary Sample Mental Health. Psychiatric Discharge Summary Sample Report #4. Bate [5] defined beneficence as the quality of doing good, taking positive steps to help others, or the notion that one ought to do or promote action that benefits others (p. 343). Dictated by: Dr Gary Marhsall . This will not be included on transfer summaries or off-service notes. Admission Date: 08/01/14 . physician. Discharge planners, given the enormous task of interpreting those factors, your current mental and medical status, among. Persons no longer resident within the service’s catchment area. Gallery of Discharge Summary Sample Mental Health. Patient Name – full name of the patient (also the patient’s preferred name if relevant) 2. (A) Each provider shall have policies and procedures addressing the completion of discharge summaries. discharge planning and preparation on the behavioral. G'day, Student enrolled nurse here. For example, to our knowledge Walker et al., is the only study to specifically test ‘discharge co-ordinators’ in relation to mental health, despite evidence that this method is effective in other patient populations and its inclusion in the UK National Institute for Health and Care Excellence (NICE) guideline regarding transitional care . There are several examples of mental health treatment plans to be found online, and several are linked below: This sample treatment plan is for a young Medicaid recipient struggling with symptoms of depression and suicidal thoughts. Mental Health Progress Note Documentation Sample. Examples of Mental Health Treatment Plans. 11/17 Discharge Summary Reason for termination (was patient in agreement with termination at this time): If patient did not return for scheduled appointment, were attempt(s) made to contact nursing home discharge planning checklist. Previous Post Next Post . January 22, 2018 by Dora. DATE OF ADMISSION: MM/DD/YYYY. 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